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A nationwide survey of adherence to analgesic drugs among cancer patients in Taiwan: prevalence, determinants, and impact on quality of life

  • Wen-Chi ChouEmail author
  • Jen-Shi Chen
  • Chia-Yen Hung
  • Chang-Hsien Lu
  • Yu-Yun Shao
  • Tzeon-Jye Chiou
  • Yung-Chuan Sung
  • Kun-Ming Rau
  • Chia-Jui Yen
  • Su-Peng Yeh
  • Ta-Chih Liu
  • Ming-Fang Wu
  • Ming-Yang Lee
  • Ming-Sun Yu
  • Wen-Li Hwang
  • Pang-Yu Lai
  • Cheng-Shyong Chang
  • Ruey-Kuen Hsieh
Original Article
  • 56 Downloads

Abstract

Purpose

Poor adherence to analgesic drugs is one of the most common barriers to adequate pain management. This prospective, cross-sectional, patient-oriented observational study aimed to explore the adherence rate, clinical factors, and impact of adherence to analgesic drugs on the quality of life (QoL) among cancer outpatients in Taiwan.

Methods

Eight hundred ninety-seven consecutive adult outpatients with cancer who had reported tumor pain and received regular analgesic drug treatment were enrolled from 16 medical centers across Taiwan. The Brief Pain Inventory was used to assess pain intensity and QoL. Morisky’s four-item medication adherence scale was used to assess adherence to analgesic drugs. Clinical factors possibly associated with good adherence to analgesic drugs were analyzed using multivariate logistic regression analyses.

Results

Of the 897 patients, 26.9% met criteria for the good, 35.5% for the moderate, and 37.6% for the poor adherence groups. The good adherence group had significantly better QoL outcomes than the moderate and poor adherence groups (all p < 0.05). Age ≥ 50 years, head and neck or hematological malignancies, cancer-related pain, patients who agreed or strongly agreed that the side effects of analgesic drugs were tolerable, and patients who disagreed or strongly disagreed that the dosing schedule could be flexibly self-adjusted to deal with the actual pain were predictors of good adherence to analgesic drugs.

Conclusions

Awareness of the clinical factors associated with adherence to analgesic drugs may help clinicians to identify cancer patients at a greater risk of non-adherence, reinforce optimal pain management, and improve the QoL by enhancing adherence to pain medications.

Keywords

Cancer Pain Adherence Predictive factor Quality of life 

Notes

Compliance with ethical standards

Acknowledgements

The authors gratefully acknowledge the assistance of the patients who participated in this study, and support grants from the Taiwan Society of Cancer Palliative Medicine and Johnson & Johnson.

Conflicts of interest

The authors declare that they have no competing interests.

Supplementary material

520_2018_4599_MOESM1_ESM.docx (14 kb)
Supplementary Table 1 (DOCX 14 kb)
520_2018_4599_MOESM2_ESM.docx (14 kb)
Supplementary Table 2 (DOCX 13 kb)
520_2018_4599_MOESM3_ESM.docx (14 kb)
Supplementary Table 3 (DOCX 14 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Wen-Chi Chou
    • 1
    Email author
  • Jen-Shi Chen
    • 1
  • Chia-Yen Hung
    • 1
    • 2
  • Chang-Hsien Lu
    • 3
  • Yu-Yun Shao
    • 4
  • Tzeon-Jye Chiou
    • 5
  • Yung-Chuan Sung
    • 6
  • Kun-Ming Rau
    • 7
  • Chia-Jui Yen
    • 8
  • Su-Peng Yeh
    • 9
  • Ta-Chih Liu
    • 10
  • Ming-Fang Wu
    • 11
  • Ming-Yang Lee
    • 12
  • Ming-Sun Yu
    • 13
  • Wen-Li Hwang
    • 14
  • Pang-Yu Lai
    • 15
  • Cheng-Shyong Chang
    • 16
  • Ruey-Kuen Hsieh
    • 2
  1. 1.Division of Hematology-Oncology, Department of Internal Medicine, Linkuo Chang Gung Memorial Hospital and College of MedicineChang Gung UniversityTaoyuan CountyTaiwan
  2. 2.Division of Hematology-Oncology, Department of Internal MedicineMackay Memorial HospitalTaipeiTaiwan
  3. 3.Division of Hematology-Oncology, Department of Internal MedicineChiayi Chang Gung Memorial HospitalChiayiTaiwan
  4. 4.Department of OncologyNational Taiwan University HospitalTaipeiTaiwan
  5. 5.Division of Hematology-OncologyTaipei Veterans General HospitalTaipeiTaiwan
  6. 6.Division of Hematology-OncologyCathay General HospitalTaipeiTaiwan
  7. 7.Division of Hematology-Oncology, Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalKaohsiungTaiwan
  8. 8.Division of Hematology-OncologyNational Cheng Kung University HospitalTainanTaiwan
  9. 9.Division of Hematology-OncologyChina Medical University HospitalTaichungTaiwan
  10. 10.Division of Hematology-OncologyKaohsiung Medical University Chung-Ho Memorial HospitalKaohsiungTaiwan
  11. 11.Divisions of Medical Oncology and Chest Medicine, Chung Shan Medical University Hospital, School of MedicineChung Shan Medical UniversityTaichungTaiwan
  12. 12.Division of Hematology-OncologyDitmanson Medical Foundation Chiayi Christian HospitalChiayiTaiwan
  13. 13.Division of Hematology-OncologyKaohsiung Veterans General HospitalKaohsiungTaiwan
  14. 14.Division of Hematology-OncologyTaichung Veterans General HospitalTaichungTaiwan
  15. 15.Division of Hematology-OncologyE-DA HospitalKaohsiungTaiwan
  16. 16.Division of Hematology-OncologyChanghua Christian HospitalChanghuaTaiwan

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